O6-7 Community sport coach's potential to enhance health

Abstract In 2008 Community sport coaches (CSC) were introduced in the Netherlands as a policy instrument to motivate inhabitants to become physically active, by connecting the sport sector with other sectors (e.g. health, education). Almost 6000 CSC are currently active throughout 98% of Dutch municipalities. We used Jolley's model to examine the use of CSC as a complex local sport policy instrument for health enhancement (Jolley, 2014; Van Lindert et al., 2017). The question we aimed to answer was: To which extent is the CSC program used for health enhancement? We will share the impact of this policy program in the Netherlands and discuss the relevance and implications for other countries. In 2019, we conducted an online questionnaire to examine the health incentives and outcomes (e.g. sectors, target groups, goals) of local CSC programmes among all municipalities implementing CSC (n = 347). We also surveyed our CSC (n = 100) and CSC employers (n = 27) panels about their work on health enhancement. Findings show that health enhancement is not often an explicit goal of CSC programmes. No national goals of the program address health explicitly and only 27% of municipal goals for CSC are focused on health. Nevertheless, the governmental health department and/or local health parties are often (82%) involved in CSC policy decision making (e.g. by paying part of the finances and/or by employing CSC). This results in a contribution to health enhancement of almost all (98%) local CSC programmes. Findings show that CSC connect the sport sector with the health sector in 96% of the municipalities, coaches/employers have often collaborated with health organisations last year (respectively 81% and 100%) and/or CSC work with inactive and/or overweighed inhabitants (69%)). CSC are responsible for motivating people to become physically active, and logically this has an impact on health. Despite the lack of explicit goals, local CSC programmes are intertwined with health incentives and outcomes. But often the exact effects on health are unknown. More explicit and specific health goals may increase the impact of sport policy on health enhancement. Facilitators and barriers relevant to further national and international implementation of CSC programmes will be discussed.


Background
Public policy is increasingly recognized as an important component of physical activity (PA) promotion, as policy actions to address lifestyle behaviours have the potential to in?uence the health and well-being of an entire population. However, our knowledge about the current status, implementation and effectiveness of PA policies in individual countries is still very limited, and there is consequently no clear guidance on which policies governments should preferably use in different settings or under various preconditions. In order to improve the evidence-base, we conducted a detailed assessment of existing PA policies in four EU Member States using WHO's HEPA Policy Audit Tool (PAT) in the context of the Policy Evaluation Network (PEN).

Methods
We employed a six-step process to administer the HEPA PAT Version 2 in Ireland, the Netherlands, Germany, and Poland. This involved identifying stakeholders, pre-filling parts of the tool using existing survey data and desk-research, approaching select institutions to verify details, and obtaining expert opinion via workshops, interviews, and/or questionnaires. Based on the four completed PATs, we performed a comparative analysis to identify similarities and differences between countries and with previous studies using the tool.

Results
In all four countries, the health and sport sector were found to be most active in PA promotion, followed by education, transport, and environment/urban planning. All countries have national systems to monitor population PA levels, and three out of four already have national PA recommendations. The study also showed that policy context (e.g. ministry portfolios, importance of subnational governments) varies substantially between countries. This influences policy implementation and made it necessary to employ a bespoke approach in each country to obtain the required information.

Conclusions
Our findings largely confirm results of previous studies using the PAT in other countries. They also indicate that using the tool in combination with other policy monitoring tools, e.g. the EU Monitoring Framework for HEPA across Sectors, may provide added value and help countries monitor policy progress more consistently. Our experience also confirms Abstract citation ID: ckac094.047 O6-7 Community sport coach's potential to enhance health In 2008 Community sport coaches (CSC) were introduced in the Netherlands as a policy instrument to motivate inhabitants to become physically active, by connecting the sport sector with other sectors (e.g. health, education). Almost 6000 CSC are currently active throughout 98% of Dutch municipalities. We used Jolley's model to examine the use of CSC as a complex local sport policy instrument for health enhancement (Jolley, 2014;Van Lindert et al., 2017). The question we aimed to answer was: To which extent is the CSC program used for health enhancement? We will share the impact of this policy program in the Netherlands and discuss the relevance and implications for other countries. In 2019, we conducted an online questionnaire to examine the health incentives and outcomes (e.g. sectors, target groups, goals) of local CSC programmes among all municipalities implementing CSC (n = 347). We also surveyed our CSC (n = 100) and CSC employers (n = 27) panels about their work on health enhancement. Findings show that health enhancement is not often an explicit goal of CSC programmes. No national goals of the program address health explicitly and only 27% of municipal goals for CSC are focused on health. Nevertheless, the governmental health department and/or local health parties are often (82%) involved in CSC policy decision making (e.g. by paying part of the finances and/or by employing CSC). This results in a contribution to health enhancement of almost all (98%) local CSC programmes. Findings show that CSC connect the sport sector with the health sector in 96% of the municipalities, coaches/employers have often collaborated with health organisations last year (respectively 81% and 100%) and/or CSC work with inactive and/or overweighed inhabitants (69%)). CSC are responsible for motivating people to become physically active, and logically this has an impact on health. Despite the lack of explicit goals, local CSC programmes are intertwined with health incentives and outcomes. But often the exact effects on health are unknown. More explicit and specific health goals may increase the impact of sport policy on health enhancement. Facilitators and barriers relevant to further national and international implementation of CSC programmes will be discussed. Keywords: Community sport coach, Local sport policy instrument, Local implementation Abstract citation ID: ckac094.048 O6-8 Rethinking schools as a setting for physical activity promotion in the 21st Century -A position paper from the Erasmus+ 2PASS 4Health project Background Schools are ideally placed to provide children and adolescents with multiple opportunities to be or learn to be physically active. However, key reviews have reported that interventions to date have largely failed to have any long-term impact on overall physical activity levels. In this position paper, greater attention to key issues is needed to realise the full potential of schools and ideal physical activity for health promotion setting.

Methods
This study draws on multi-author expertise to develop a position paper to advance opinion on school-based programmes. Collaborative conceptual thinking was established through various tools such as literature review, evidence synthesis and online and in person meetings.

Results/Discussion
The adoption of a systems approach is valuable for understanding the complexities of the school setting and to support the implementation of whole-of-school initiatives. Furthermore, we contend that the full range of physical, cognitive, emotional and social benefits that physical activity provides should be considered, rather than a narrow focus solely on physical activity levels. Interdisciplinary research questions are most useful in exploring and evaluating wholeof-school approaches. Informed by process, impact and outcome evaluation and implementation science, both qualitative and quantitative research methodologies and a move beyond traditional research design are needed to advance our knowledge of what works, for whom and in what context. Case studies from several European countries will be presented to illustrate examples of systems approaches in action. This includes examples at multiple levels firstly, a national approach including a Physical Education curriculum reformation (Portugal), a regional approach such as a county council partnership with a University to support physical activity promotion (France) and a local approach at the school level i.e. a whole-of-school physical activity programme (Spain and Ireland).

Conclusion
From authors expertise and reflection, this paper makes recommendations on the nature of the evidence required to Background Physical activity is a key determinant for health and considered as an important factor in the prevention of lifestyle time physical activity. Our aim was to assess the association of occupational and leisure time physical activity and all-cause mortality.

Methods
We obtained individual participant data from published and unpublished cohort studies and assessed their risk of bias. We harmonized the data, and used Cox survival regression models to assess the association between occupational and leisure time physical activity with all-cause mortality, in a two-stage individual participant data meta-analysis. Different models were performed to assess the impact of relevant confounders including behavioral, health-related and socio-economic